[1]崔海玲,林 虹.冠心病心肌缺血后心电图波形变化规律与炎性因子表达关系[J].陕西医学杂志,2022,51(4):445-448,453.[doi:DOI:10.3969/j.issn.1000-7377.2022.04.014]
　CUI Hailing,LIN Hong.Relationship between changes of electrocardiogram waveform and expression of inflammatory factors after myocardial ischemia in coronary heart disease[J].,2022,51(4):445-448,453.[doi:DOI:10.3969/j.issn.1000-7377.2022.04.014]
点击复制

冠心病心肌缺血后心电图波形变化规律与炎性因子表达关系
分享到：

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
51
期数:
2022年4期
页码:
445-448,453
栏目:
临床研究
出版日期:
2022-04-05

文章信息/Info

Title:
Relationship between changes of electrocardiogram waveform and expression of inflammatory factors after myocardial ischemia in coronary heart disease
作者:
崔海玲1; 林 虹2
(1.延安市人民医院功能科,陕西 延安 716000; 2.商洛职业技术学院附属医院心电图室,陕西 商洛 726000)
Author(s):
CUI Hailing; LIN Hong
(Department of Function,Yan'an People's Hospital,Yan'an 716000,China)
关键词:
冠心病;  心肌缺血;  心电图;  炎性因子;  QRS;  心功能;  相关性
Keywords:
Coronary heart disease;  Myocardial ischemia;  Electrocardiogram;  Inflammatory factors;  QRS;  Cardiac function;  Correlation
分类号:
R 541.4
DOI:
DOI:10.3969/j.issn.1000-7377.2022.04.014
文献标志码:
A
摘要:
目的:探讨与分析冠心病心肌缺血后心电图波形变化规律与炎性因子表达的关系。方法:选择冠心病心肌缺血患者88例与冠心病非心肌缺血患者88例作为心肌缺血组与非心肌缺血组,所有患者都给予心电图、超声心功能检查,检测血清炎性因子表达水平并进行相关性分析。结果:两组的心电图RR间期、T波时限、PR间期比较差异无统计学意义(均P>0.05),心肌缺血组的QRS时限低于非心肌缺血组(P<0.05)。心肌缺血组的血清C-反应蛋白(CRP)与白介素(IL)-6含量高于非心肌缺血组(P<0.05)。心肌缺血组的左室舒张末内径(LVEDD)、左室收缩末内径(LVESD)、左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)高于非心肌缺血组(均P<0.05),左室射血分数(LVEF)低于非心肌缺血组(P<0.05)。在心肌缺血组中,Pearson分析显示QRS时限与LVEF存在正相关性(P<0.05),与CRP、IL-6、LVEDD、LVESD、LVESV、LVEDV存在负相关性(均P<0.05)。ROC曲线显示QRS时限诊断冠心病心肌缺血的曲线下面积为0.597,诊断敏感性与特异性分别为65.9%和71.4%。结论:冠心病心肌缺血可伴随有心电图波形变化异常与炎性因子的大量释放,QRS时限与患者的心功能与炎性因子表达存在相关性,诊断冠心病心肌缺血也有很好的价值。
Abstract:
Objective:To explore and analysis the relationship between the changes of electrocardiogram waveform and the expression of inflammatory factors after myocardial ischemia in coronary heart disease.Methods:88 cases of patients with coronary heart disease myocardial ischemia were selected as the myocardial ischemia group,and 88 cases of patients with coronary heart disease and non-myocardial ischemia were selected as non-myocardial ischemia group.All patients were given ECG and ultrasonic cardiac function examination,and the expression levels f serum inflammatory factors were detected and the correlation analysis was carried out.Results:There was no significant difference in RR interval,T wave duration and PR interval between the two groups(all P>0.05).The QRS duration of myocardial ischemia group was lower than that of non-myocardial ischemia group(P<0.05).Serum levels of C-reactive protein(CRP)and interleukin(IL)-6 in the myocardial ischemia group were higher than those in the non-myocardial ischemic group(all P<0.05).The left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),left ventricular end systolic volume(LVESV)and left ventricular end diastolic volume(LVEDV)in myocardial ischemia group were higher than those in non-myocardial ischemia group,and the left ventricular ejection fraction(LVEF)was lower than that in non-myocardial ischemia group(all P<0.05).In myocardial ischemia group,Pearson analysis showed that QRS duration was positively correlated with LVEF,and negatively correlated with CRP,IL-6,LVEDD,LVESD,LVESV and LVEDV(all P<0.05).ROC curve analysis showed that the area under the curve for QRS duration in diagnosis of coronary heart disease myocardial ischemia was 0.597,and the sensitivity and specificity were 65.9% and 71.4%,respectively.Conclusion:Coronary heart disease myocardial ischemia can be accompanied by abnormal changes in ECG waveform and the release of a large amount of inflammatory factors.QRS duration is correlated with cardiac function and expression of inflammatory factors in patients with coronary heart disease.It is also of great value in diagnosing myocardial ischemia of coronary heart disease.

参考文献/References:

[1] 刘学安,喻晶晶.大株红景天注射液对急性冠脉综合征患者血运重建后心肌缺血-再灌注损伤的作用[J].陕西中医,2017,38(7):871-873.
[2] 黄敏华,孙雁智.稳定性冠心病患者血清抵抗素水平与心肌梗死相关性研究[J].陕西医学杂志,2020,49(2):187-189,208.
[3] 王亚平,彭春艳,朱名安.冠心病合并代谢综合征患者固醇调节元件结合蛋白表达水平与脂代谢指标相关性研究[J].陕西医学杂志,2020,49(4):419-423,438.
[4] Ali ZA,Karimi-Galougahi K,Maehara A,et al.Outcomes of optical coherence tomography compared with intravascular ultrasound and with angiography to guide coronary stent implantation:One-year results from the ILUMIEN Ⅲ:OPTIMIZE PCI trial[J].EuroIntervention,2021,16(13):1085-1091.
[5] 王 娜,杨 琳.薤白通脉汤加减对冠心病不稳定型心绞痛患者中医证候积分及血清VEGF、Hcy水平的干预作用[J].陕西中医,2020,41(10):1388-1391.
[6] 武卫党,石 磊,张丹凤,等.达格列净对糖尿病心肌缺血大鼠心肌功能改善作用的实验研究[J].陕西医学杂志,2020,49(7):778-780.
[7] 李艳艳,贾 伟.24 h动态心电图在2型糖尿病合并冠心病患者心律诊断中的价值分析[J].陕西医学杂志,2019,48(1):61-63,70.
[8] 许三雄,程蕾群.缬沙坦对冠心病患者心功能和炎性因子水平的影响研究[J].心血管康复医学杂志,2020,29(1):77-81.
[9] 时长琴,龚艳艳,潘令新.心电图改变对急性前壁心肌梗死患者病情进展的影响[J].中国循证心血管医学杂志,2021,13(6):738-741.
[10] 孙龙飞,谢晓柳,古丽加玛力?尼亚孜,等.天香丹对冠心病稳定型心绞痛病人临床疗效及血清中炎性因子IL-1β和TNF-α的影响[J].中西医结合心脑血管病杂志,2019,17(3):334-337.
[11] 余小佳,兀花妮,白一苹,等.动态心电图应用于临床诊断冠心病无症状性心肌缺血的效果评价[J].贵州医药,2021,45(2):290-291.
[12] 董 静.三维超声心动图评价冠心病心力衰竭病人左心功能及其与血清NT-proBNP、H-FABP水平的相关性分析[J].中西医结合心脑血管病杂志,2020,18(22):3837-3840.
[13] Yamamoto K,Matsumura-Nakano Y,Shiomi H,et al.Effect of heart failure on long-term clinical outcomes after percutaneous coronary intervention versus coronary artery bypass grafting in patients with severe coronary artery disease[J].J Am Heart Assoc,2021,10(15):e021257.
[14] 盖兢泾,张 闯,金琴花,等.胸痛特征诊断冠心病的准确性[J].中华老年多器官疾病杂志,2021,20(3):202-205.
[15] Burzotta F,Lassen JF,Lefèvre T,et al.Percutaneous coronary intervention for bifurcation coronary lesions:The 15(th)consensus document from the European Bifurcation Club[J].EuroIntervention,2021,16(16):1307-1317.
[16] 黎维桃.十二导联动态心电图对冠心病心肌缺血发作患者的诊断价值研究[J].影像科学与光化学,2020,38(1):52-58.
[17] 严 诚,黄健峰,张利军,等.基于工作站的CT-FFR对评估冠状动脉功能性狭窄的临床初步探究[J].复旦学报:医学版,2021,48(3):356-362.
[18] 邹 青,卢少平,张明明,等.FIB和TNF-α联合检测对冠心病患者PCI术后心肌缺血再灌注损伤的预测价值[J].临床误诊误治,2021,34(6):71-75.
[19] Noutsias M,Rigopoulos AG,Ali M,et al.Acute myocardial ischemia in a patient with coronary-subclavian steal syndrome treated by retrograde percutaneous recanalization of the chronic total occlusion of the left subclavian artery[J].Hellenic J Cardiol,2021,62(3):225-227.
[20] Olesen KKW,Gyldenkerne C,Thim T,et al.Peripheral artery disease,lower limb revascularization,and amputation in diabetes patients with and without coronary artery disease:A cohort study from the Western Denmark Heart Registry[J].BMJ Open Diabetes Res Care,2021,9(1):1113-1119.
[21] 冷 婧,魏首栋,庞工力,等.血清同型半胱氨酸叶酸C反应蛋白水平与冠心病严重程度相关性[J].中国药物与临床,2021,21(12):2076-2079.
[22] 王文娟,吴祥芝,谢 燕,等.不同联合检查方法对无症状心肌缺血患者冠状动脉病变程度的诊断价值[J].实用临床医药杂志,2021,25(3):86-88,93.

相似文献/References:

[1]李艳艳,贾 伟△.24h动态心电图在2型糖尿病合并冠心病患者心律诊断中的价值分析[J].陕西医学杂志,2019,(1):61.
[2]汤克虎,高峻峰,任尽平.药物涂层球囊在糖尿病患者冠状动脉小血管病变治疗中的应用研究*[J].陕西医学杂志,2019,(4):432.
[3]马党捐 ,康彦智 ,柴茂林.64排128层螺旋CT冠状动脉成像在冠心病患者诊断中的价值研究*[J].陕西医学杂志,2019,(5):624.
　MA Dangjuan,KANG Yanzhi,CHAI Maolin..Value analysis of 64rows 128slice spiral CT coronary angiography in the diagnosis of patients with coronary heart disease[J].,2019,(4):624.
[4]沈 琳,马文苑.曲美他嗪联合氯吡格雷治疗冠心病心绞痛疗效及对患者心电图、血清超敏C反应蛋白和五聚素3的影响[J].陕西医学杂志,2019,(6):794.
　SHEN Lin,MA Wenyuan.ElectrocardiogramRoom,Therapeutic Effect ofTrimetazidine Combined with Clopidogrel on Angina Pectoris and its Hs-CRP[J].,2019,(4):794.
[5]杨延洁,周慧龙△.不同双抗血小板疗程对冠心病合并房颤PCI术后患者远期预后的影响*[J].陕西医学杂志,2019,(12):1653.
[6]魏 勇,梁 琪,左浩源,等.右美托咪定预处理对冠心病非心脏手术患者心肌的保护作用*[J].陕西医学杂志,2019,(12):1706.
　WEI Yong,LIANG Qi,ZUO Haoyuan,et al.Protective effect of dexmedetomidine preconditioning on myocardium in patients with coronary heart disease undergoing nonheart surgery[J].,2019,(4):1706.
[7]刘玉珊.心外膜脂肪定量及可溶性血栓调节蛋白与冠心病病变程度相关性分析[J].陕西医学杂志,2020,49(1):44.
　LIU Yushan..Correlation between the distribution of epicardial adipose tissue and soluble thrombomodulin and the severity of coronary heart disease[J].,2020,49(4):44.
[8]赵 博,王银谦,王红燕.巨噬细胞移动抑制因子与冠心病关系Meta分析[J].陕西医学杂志,2020,49(1):125.
[9]王亚平,彭春艳,朱名安Δ.冠心病合并代谢综合征患者固醇调节元件结合蛋白表达水平与脂代谢指标相关性研究*[J].陕西医学杂志,2020,49(4):419.
　WANG Yaping,PENG Chunyan,ZHU Mingan..Correlation between the levels of SREBPs and the indicators of lipid metabolism in patients with coronary heart disease complicated with metabolic syndrome[J].,2020,49(4):419.
[10]南格利.冠心病颈动脉超声参数与斑块稳定性及炎症反应水平相关性分析[J].陕西医学杂志,2020,49(4):453.
　NAN Geli..Correlation between carotid ultrasound parameters and plaque stability and inflammatory response in patients with coronary heart disease[J].,2020,49(4):453.
[11]古丽尼格尔·吾布力,夏木西娅·哈德尔,印纹源,等.冠心病患者动态心电图检查中P波离散度、T波峰-末间期的变化及诊断价值研究[J].陕西医学杂志,2024,(5):620.[doi:DOI:10.3969/j.issn.1000-7377.2024.05.009]
　WUBULI·Gulinigeer,HADEER·Xiamuxiya,YIN Wenyuan,et al.Changes and diagnostic value of P-wave dispersion and T peak-T end interval in dynamic electrocardiogram in patients with coronary heart disease[J].,2024,(4):620.[doi:DOI:10.3969/j.issn.1000-7377.2024.05.009]

备注/Memo

备注/Memo:
基金项目:陕西省重点研发计划项目(2021SF-312)
更新日期/Last Update: 2022-04-07